Chapter 4, Health of the Individual, Family, and Community
A nurse caring for a client in a long-term health care facility measures his intake and output and weighs him to assess water balance. These actions help to meet which of Maslow's hierarchy of needs? A) Physiologic B) Safety and security C) Love and belonging D) Self-actualization
Ans: A Feedback: A balance between the intake and elimination of fluids is essential to life and is, therefore, a physiologic need, according to Maslow's hierarchy of needs. Measuring intake and output, testing the resiliency of the skin, checking the condition of the skin and mucous membranes, and weighing the patient all help the nurse assess water balance.
The nurse is planning interventions to promote the health of a family struggling with loss of energy and privacy for the parents. In which family stage is the family? A) Family with young children B) Family with adolescents and young adults C) Family with middle-aged adults D) Family with older adults
Ans: A Feedback: A family with young children needs to cope with loss of energy and privacy of the parents. A family with adolescents and young adults must balance the teenagers' freedom with responsibility. A family with middle-aged adults strives to maintain ties with both younger and older generations. A family with older adults may contemplate moving from the family home they have lived in for years.
C) The community will open a senior citizens center by March 9. D) The community will identify a walking path through the community by February 2.
Ans: A Feedback: Availability of an effective wastewater disposal system will promote the safety of the community. Physical activity, such as availability of a walking path, is essential for Maslow's physiologic needs. Availability of a senior citizens center represents a solution to feeling love and belonging for older adults. Self-esteem and pride is demonstrated by welcome signs and flowers at the edge of town.
Which of the following individuals would the nurse assess as being most at risk for altered family health? A) An unmarried adolescent with a newborn B) A newly married couple who ask about birth control C) A middle-aged man and woman with no children D) An older adult, living in an assisted-living community
Ans: A Feedback: It is important for the nurse to assess a client's family for family risk factors that may cause health problems. A developmental risk factor for family health is an unmarried adolescent mother who lacks personal, economic, and educational resources.
The community health nurse is creating a plan of care for a client with Parkinson's disease. The client's spouse has provided care to the client for the past five years and the client's care needs are increasing. What is an appropriate nursing diagnosis for the client and family? A) Risk for Caregiver Role Strain. B) Health Seeking Behaviors. C) Parental Role Conflict. D) Readiness for Enhanced Family Processes.
Ans: A Feedback: Long-term care of a family member with a chronic illness may lead to caregiver role strain, so the most appropriate nursing diagnosis is "Risk for Caregiver Role Strain."
The nurse who is caring for a child admitted after an automobile accident recognizes the importance of including the child's family in the plan of care. Inclusion of the family meets which of Maslow's basic human needs? A) Love and belonging B) Physiologic C) Self-esteem D) Self-actualization
Ans: A Feedback: Love and belonging needs include the understanding and acceptance of others in both giving and receiving love, and the feeling of belonging to families, peers, friends, a neighborhood, and a community. The inclusion of family and friends in the care of a client is a nursing intervention to meet this need.
Which of the following statements accurately describes how Maslow's theory can be applied to nursing practice? A) Nurses can apply this theory to the nursing process. B) Nurses can identify met needs as health care needs. C) Nurses cannot use the theory on infants or children. D) Nurses use the theory for ill, as opposed to healthy, patients.
Ans: A Feedback: Nurses can apply Maslow's hierarchy of basic needs in the assessment, planning, implementation, and evaluation of patient care. The hierarchy can be used with patients at any age, in all settings where care is provided, and in both health and illness. It helps the nurse identify unmet needs as they become health care needs.
What is one method by which a nurse can be a role model to promote health in the community? A) Demonstrating a healthy lifestyle B) Becoming a member of a family C) Meeting own basic needs D) Exhibiting self-actualization
Ans: A Feedback: Nurses promote health in the community by providing health care services in a variety of settings, by serving as volunteers in health-related activities, and by being role models for health practices and lifestyles.
According to Maslow's basic human needs hierarchy, which needs are the most basic? A) Physiologic B) Safety and security C) Love and belonging D) Self-esteem
Ans: A Feedback: Physiologic needs, the most basic in the hierarchy of needs, are the most essential to life and have the highest priority. Physiologic needs include oxygen, water, food, temperature, elimination, sexuality, physical activity, and rest.
The nursing student is assessing a community in regard to safety and security. Which of the following would be inappropriate for the nursing student to include under this basic need category? A) Parks and swimming pools B) Police and fire departments C) Sanitation facilities D) Housing and zoning codes
Ans: A Feedback: Police and fire departments, sanitation facilities, and housing and zoning codes protect the safety of the members of the community. Parks and swimming pools provide recreation for the members, meeting physiological needs.
An unmarried couple in a committed relationship live together with their adopted twin boys. Which of the following best describes this type of family? A) Nuclear family B) Extended family C) Blended family D) Adoptive family
Ans: A Feedback: The nuclear family, also called the traditional family, is composed of two parents and their children. The parents might be heterosexual or homosexual, are often married or in a committed relationship, and all members of the family live in the same house until the children leave home as young adults. The nuclear family may be composed of biologic parents and children, adoptive parents and children, surrogate parents and children, or stepparents and children.
A nurse assigned to a client's care schedules a family assessment of the client. Which of the following should the nurse use for basic family assessment? A) Interview B) Physical assessment C) Survey D) Poll
Ans: A Feedback: The nurse should use an interview for the basic family assessment. Physical assessment is used for individual assessment. Surveys and polls are used for community assessment.
During the course of assessing the family structure and behaviors of a pediatric patient's family, the nurse has identified a number of highly significant risk factors. Which of the following actions should the nurse prioritize when addressing these risk factors? A) Engage in appropriate health promotion activities. B) Validate the family's unique way of being. C) Enlist the help of community and social support. D) Introduce the family to another family that possesses fewer risk factors.
Ans: A Feedback: The role of the nurse in reducing risk factors involves activities that promote health for all family members at any level of development. This consideration supersedes the importance of validating the family's current way of being or enlisting the help of others. Introducing the family to a "model" family is ethically and logistically questionable.
The nurse is assessing the functions of a family. Which items are functions of the family? Select all that apply. A) Provide a safe, comfortable home in which to reside. B) Communicate cultural values and beliefs to family members. C) Provide emotional support to family members. D) Secure adequate income to meet the needs of the family. E) Make referrals to community-based healthcare resources
Ans: A, B, C, D Feedback: Family functions include: (1) providing a safe, comfortable home; (2) securing adequate income; (3) providing emotional support; and (4) communicating cultural values and beliefs. Nurses make referrals to community-based health care agencies to secure resources for families in need.
Which of the following statements accurately describes a characteristic of a community? A) Communities do not exist in rural areas. B) Communities are formed by the characteristics of people and other factors. C) Communities are not limited by geographic boundaries. D) Communities have little or no effect of the health of residents.
Ans: B Feedback: A community is a specific population or group of people living in the same geographic area under similar regulations and having common values, interests, and needs. A community may be a small neighborhood in a major urban city or a large rural area encompassing a small town. Communities are formed by the characteristics of people, area, social interaction, and common familial, cultural, or ethnic heritage and ties. Within a community, people interact and share resources. Many community factors affect the health of residents.
The nurse conducting a community emergency preparedness education class includes which of the following as an example of a natural disaster? A) Toxic spill B) Earthquake C) War D) Terrorist event
Ans: B Feedback: A disaster is broadly defined as a tragic event of great magnitude that requires the response of people outside the involved community. Disasters can be categorized as natural (e.g., massive flooding following a hurricane or an earthquake) or man-made (e.g., a toxic spill, war, or a terrorist event).
Which of the following groups involves all parts of a person's life and is concerned with meeting basic human needs to promote health? A) Peers B) Family C) Community D) Health care providers
Ans: B Feedback: Almost every person is a member of a number of groups, such as friends, colleagues at work, or members of a church or school class. Each of these groups involves a specific part of the person's life and is important to the person. Only the family, however, is concerned with all parts of a person's life and with meeting his or her basic human needs to promote health.
Five functions have been identified as being essential to the growth of individuals and families. One of these functions is education and support. How is support manifested in the context of coping with crisis and illness situations? A) Making clear distinctions between the generations B) Actions that tell family members they are cared about and loved C) The promotion of exercise in the lifestyle D) Transmitting culture and acceptable behaviors
Ans: B Feedback: Five family functions are viewed as essential to the growth of individuals and families. The first function, management, involves the use of power, decision making about resources, establishment of rules, provision of finances, and future planning —responsibilities assumed by the adults of the family. The second function, boundary setting, makes clear distinctions between the generations and the roles of adults and children within the family structure. The third function, communication, is important to individual and family growth; healthy families have a full range of clear, direct, and meaningful communication among their members. The fourth function is education and support. Education involves modeling skills for living a physically, emotionally, and socially healthy life. Support is manifested by actions that tell family members they are cared about and loved; it promotes health and is seen as a critical factor in coping with crises and illness situations. The fifth function, socialization, involves families' transmission of culture and the acceptable behaviors needed to perform adequately in the home and in the world.
What is the major effect of a health crisis on family structure? A) Adaptation to stress B) Change in roles of family members C) Respect for family values D) Loss of individual identities
Ans: B Feedback: Illness may precipitate a health crisis in a family. Serious illness or injury may result in changes in family roles, responsibilities, and functions. Regardless of how the family adapts to an illness, members of the family must constantly adjust roles and responsibilities to manage the needs of the ill family member.
Which of the following is an example of a community factor that may affect health? A) Rural setting B) Air and water quality C) Number of residents D) Educational level
Ans: B Feedback: The health of a community is affected by the social support systems, the community health structure, environmental factors, and types of agencies providing assistance for those in need of shelter, housing, and food. Air pollution and water pollution are community risk factors that may affect health. Living in a rural setting, the number of residents, and/or educational level are not factors in the community that are considered to affect health.
A boy age 2 years arrives at the emergency department of a local hospital with difficulty breathing from an asthmatic attack. Which of the following would be the priority nursing intervention? A) Giving him his favorite stuffed animal to hold B) Assessing respirations and administering oxygen C) Raising the side rails and restraining his arms D) Asking his mother what are his favorite foods
Ans: B Feedback: The priority need for a child having respiratory difficulty is for oxygen. Therefore, the nurse's immediate interventions should be to meet physiologic oxygen needs by assessing respirations and administering oxygen. Oxygen needs are more basic than are needs for food or safety and security.
A nurse provides health promotion and accident prevention programs for a family with adolescents and young adults. Which of the following is a task of a family at this stage? A) Establish a mutually satisfying marriage. B) Adjust to cost of family life. C) Maintain supportive home base. D) Maintain ties with younger and older generations.
Ans: C Feedback: Families at this stage must maintain open communication, support moral and ethical family values, balance teenagers' freedom with responsibility, maintain supportive home bases, and strengthen marital relationships.
Which of the following is a tenant of Maslow's basic human needs hierarchy? A) A need that is unmet prompts a person to seek a higher level of wellness. B) A person feels ambivalence when a need is successfully met. C) Certain needs are more basic than others and must be met first. D) People have many needs and should strive to meet them simultaneously.
Ans: C Feedback: Maslow arranged the hierarchy to show that certain needs are more basic than others. Although all people have all the needs all the time, people generally strive to meet priority needs (at least to a minimal level) before attending to other needs. The hierarchy is also based on the theory that something is a basic need if it has the following characteristics: (1) its absence results in illness, (2) its presence helps prevent illness or signals health, (3) meeting the need restores health, (4) it is preferred over other satisfactions when unmet, (5) one feels something is missing when the need is not met, and (6) one feels satisfaction when the need is met.
A man 75 years of age is being discharged to his home following a fall in his kitchen that resulted in a fractured pelvis. The home health nurse makes a home assessment that will be used to design interventions to meet which priority need? A) Sleep and rest B) Support from family members C) Protection from potential harm D) Feeling a sense of accomplishment
Ans: C Feedback: Physical safety and security means being protected from potential or actual harm. Assessing potential risks for harm in the home environment is necessary to meet physical safety needs. For this situation, protecting the patient from potential harm has a higher priority than interventions that focus on sleep and rest, support from family members, and feeling a sense of accomplishment.
What is the purpose of the affective and coping function of the family? A) Providing a safe environment for growth and development B) Ensuring financial assistance for family members C) Providing emotional comfort and identity D) Transmitting values, attitudes, and beliefs
Ans: C Feedback: The affective and coping function of the family is necessary to provide emotional comfort to family members and to help members establish an identity to be maintained in times of stress. The physical function provides a safe environment for growth and development, the economic function ensures financial assistance, and the socialization function transmits values, attitudes, and beliefs.
A couple recently married. Both the husband and the wife have previously been married and had two children. What name is given to this type of family? A) Extended family B) Nuclear family C) Blended family D) Cohabiting family
Ans: C Feedback: The blended family is one that is formed when parents bring unrelated children from previous relationships together to form a new family. An extended family includes relatives; a nuclear family is the traditional father/mother/children; a cohabiting family is composed of members who live together but are not married.
Which of the following factors may be a barrier to health care services for those living in rural areas? A) Inadequate health care insurance B) Lack of knowledge about needed care C) Living long distances from services D) Decreased interest in health promotion
Ans: C Feedback: The size and location of a community often determines the size and availability of health care services. Although urban residents have various means of transportation to a variety of health care services, rural residents may have to travel long distances for care. Rural residents do not necessarily have inadequate health care insurance, lack knowledge of needed care, or have decreased interest in health promotion.
The nursing student asks the nurse about the difference between family-centered nursing and client-centered nursing. Which of the following would be inappropriate for the nurse to include when responding to the student? A) The family is composed of interdependent members who affect one another. B) The health of the family can be improved through health promotion activities. C) A strong relationship exists between the family and the health status of its members. D) Illness of one family member infrequently occurs in other members.
Ans: D Feedback: According to Friedman and associates, family-centered nursing is based on four premises: (1) The family is composed of interdependent members who affect one another; (2) a strong relationship exists between the family and the health status of its members; (3) the health of the family can be improved through health promotion activities; and (4) illness of one family member may suggest the possibility of the same problem in other members.
When a family visits the counseling clinic for the first time, which of following activities will the nurse complete as part of the initial family assessment? A) Discuss the roles of the parents. B) Outline the basic needs of the family. C) Resolve all family conflicts. D) Interview the family members.
Ans: D Feedback: At the beginning level, a basic family assessment requires observation, comparison, and interview.
A mother teaches her son to respect his elders. This is an example of which of the following family functions? A) Physical B) Economic C) Affective and coping D) Socialization
Ans: D Feedback: Families have functions that are important in how individual family members meet their basic human needs and maintain their health. Through socialization, the family teaches; transmits beliefs, values, attitudes, and coping mechanisms; provides feedback; and guides problem solving (Friedman, Bowden, & Jones, 2003).
When providing nursing care to a client, the nurse provides family-centered nursing care. What is one rationale for this nursing action? A) The nurse does not want the client to feel lonely. B) The client will be more compliant with medical instructions. C) The family will be more willing to listen to instructions. D) Illness in one family member affects all family members.
Ans: D Feedback: Family-centered nursing care is important because the family is composed of interdependent members who affect one another. An illness in one family member affects all other members of the family; the role of the family is essential in nursing care; the level of health can be improved in all family members; illness in one family member may suggest the same problem in other family members.
Which of the following definitions best describes community-based nursing? A) A focus on populations within the community B) A focus on older adults living in nursing homes C) Care provided in the client's home for chronic illnesses D) care centered on individual and family health care needs
Ans: D Feedback: In contrast to community health nursing, which focuses on populations within a community, community-based nursing is centered on individual and family health care needs. Interventions are designed to manage health problems, promote good health, and facilitate self-care. Public health nursing focuses on populations.
A nurse caring for a female client in isolation with tuberculosis is aware that the client's love and belonging needs may not be properly met. Which of the following nursing actions would help to meet these needs? A) Respecting the patient's values and beliefs B) Focusing on the client's strengths rather than problems C) Using hand hygiene and sterile technique to prevent infection D) Encouraging family to visit and help in the care of the client
Ans: D Feedback: Love and belonging needs are met by including family and friends in the care of the client, establishing a nurse-client relationship based on mutual understanding and trust, and referring clients to specific support groups.
What action by a nurse will help a client meet self-esteem needs? A) Verbally negate the client's negative self-perceptions B) Freely give compliments to increase positive self-regard C) Independently establish goals to improve self-esteem D) Respect the client's values and belief systems
Ans: D Feedback: Self-esteem needs include the need to feel good about oneself, to feel pride and a sense of accomplishment, and to believe others respect and appreciate those accomplishments. By respecting the client's values and beliefs, the nurse can meet self-esteem needs.
An woman 80 years of age states, "I have successfully raised my family and had a good life." This statement illustrates meeting which basic human need? A) Safety and security B) Love and belonging C) Self-esteem D) Self-actualization
Ans: D Feedback: The highest level on the hierarchy of basic human needs is for self-actualization, which includes acceptance of self and others, reaching one's full potential, and feelings of happiness and affection for others.
